Abstract：
A 64-year-old female with chronic renal failure had been receiving continuous ambulatory peritoneal dialysis (CAPD). She developed acute hydrothorax in the right pleural cavity 1 year after the commencement of CAPD. Scintigraphy revealed a diagnosis of pleuroperitoneal communication, and we performed video-assisted thoracoscopic surgery. We infused a dialysis solution containing indocyanine green (ICG) through CAPD catheter. Near-infrared fluorescence thoracoscopy revealed a fistula that could not be identified by white light. We sutured the fistula covered with a polyglycolic acid sheet and fibrin glue. The CAPD was able to be resumed 8 days after surgery, and there was no recurrence of pleural effusion 10 months since surgery. Identification of the diaphragmatic fistula is important in the treatment of pleuroperitoneal communication. This technique using near-infrared fluorescence thoracoscopy with ICG was useful in identifying the fistula, and it emitted sufficient fluorescence even at low concentration ICG.
摘要：
一名患有慢性肾功能衰竭的64岁女性一直在接受连续非卧床腹膜透析（CAPD）。CAPD开始1年后，她在右胸膜腔中出现了急性胸腔积液。闪烁扫描显示胸膜腹膜通讯的诊断，我们进行了电视胸腔镜手术。我们通过CAPD导管输注了含有吲哚菁绿（ICG）的透析溶液。近红外荧光胸腔镜检查显示出无法通过白光识别的瘘管。我们缝合了用聚乙醇酸片和纤维蛋白胶覆盖的瘘管。CAPD能够在手术后8天恢复，术后10个月无胸腔积液复发。膈瘘的识别在胸膜腹膜通信的治疗中很重要。这种技术使用近红外荧光胸腔镜与ICG是有用的识别瘘，即使在低浓度ICG下也能发出足够的荧光。
